PCORI Fee Increases for 2025: What Health Plans Need to Know

The IRS issued Notice 2024-83, increasing the Patient-Centered Outcomes Research Institute (PCORI) fee for plan years ending between October 1, 2024, and September 30, 2025.

New PCORI Fee Rates

• 2025 Plan Years: $3.47 per covered life

• 2024 Plan Years: $3.22 per covered life

What is the PCORI Fee?

The PCORI fee, established by the Affordable Care Act, funds comparative effectiveness research in healthcare. Originally set to expire in 2019, it was extended through plan years ending before October 1, 2029.

Who Must Pay

1. Health insurance issuers

2. Self-insured plan sponsors

Payment Requirements

• Form: File using IRS Form 720

• Deadline: July 31, 2025 (for 2024 plan years)

• Calculation: Fee rate × average number of covered lives

Covered Lives Include

• Employees enrolled in health plans

• Enrolled spouses and dependents

• COBRA participants

Note: Special rules apply to HRAs and FSAs.

Key Compliance Facts

• Applicable Plans: Insurance policies and self-insured group health plans

• Effective Period: Plan years ending October 1, 2012 - September 30, 2029

• 2024 Payment Deadline: July 31, 2025

IRS Resources

1. PCORI Fee Overview Page

2. PCORI Fee Questions and Answers

3. PCORI Fee Due Dates and Applicable Rates

4. Application Chart for Common Health Coverage Types

Action Items

1. Calculate your average covered lives for accurate fee assessment

2. Update 2025 budgets with the new $3.47 rate

3. Mark July 31, 2025 deadline for 2024 plan year payments

4. Review IRS resources for specific compliance guidance

The 2025 PCORI fee increase affects all health plans and self-insured employers. Ensure compliance by tracking covered lives accurately and meeting payment deadlines.